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ASNC2012

ASNC Special Report: A look back at the best of ASNC2012

"People want to know what works and what doesn't work in real-life practice," ASNC program chair Dr. Robert S. Beanlands told MedPage Today ahead of this year's conference. That approach was woven throughout ASNC2012 in Baltimore, where sessions covered the latest in policy, clinical developments and practice management. This special report explores the highlights.

Study backs SPECT MPI for coronary stenosis in womenSPECT MPI shows similar sensitivity and specificity in diagnosing coronary stenosis in both women and men, according to a study presented at ASNC2012. Researchers evaluated data from 26 studies that involved 2,258 patients. The next step in this research could be to study microvascular changes in women with non-obstructive disease and normal SPECT MPI results, a researcher said. MedPage Today (free registration)
(9/8)

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Research and Technology

Stress tests may be predictive of survival, severe diseaseCompleting a stress exercise test can be predictive of survival, while the failure to do so may be predictive of severe disease, according to two Brazilian studies presented at ASNC2012. In one of the studies, 11.6% of 391 patients who were not able to achieve 85% of their maximum heart rate showed higher ischemia scores on SPECT MPI scans compared with those who finished the test. In the other study, researchers found that in patients older than 75, those who were able to complete a stress exercise test had higher survival rates compared with those who could not. MedPage Today (free registration)
(9/10)

Studies: Aminophylline beneficial with regadenoson for CKDTwo studies discussed at ASNC2012 found that aminophylline is safe to use in severe kidney disease patients undergoing stress imaging with the SPECT MPI agent regadenoson. In the first study, patients with stage IV or V chronic kidney disease who took aminophylline after injection of the agent didn't see an increase in heart rate or a decrease in blood pressure. In the second study, researchers found no significant differences in quantitative scores indicating ischemic burden between the aminophylline and placebo groups. MedPage Today (free registration)
(9/9)

Survey: More patients but fewer nuclear medicine testsU.S. cardiologists are recording more patient visits but are performing fewer advanced nuclear medicine tests, including SPECT and PET imaging, according to a joint survey from MedAxiom and ASNC released to coincide with ASNC2012. Cardiologists reported more than 2,100 patient appointments in 2011, an increase of more than 29 percent since 2004. However, on average, they performed some 356 imaging stress studies, a figure that grew only 2% over the same period, translating to one in 11 cardiology patients receiving such tests, as opposed to one in seven in 2008.

Reasons for the decline in tests include increased adoption of appropriate use criteria, more awareness on how to optimize radiation use and the limited supply of molybdenum-99. "Cardiologists have been vigilant in prescribing the appropriate use of these tests as defined by initiatives such as Choosing Wisely," said MedAxiom President Patrick White. "As health care evolves in the U.S., we intend to continue working to help cardiologists and our corporate partners clearly define the patient-centered approach to cardiovascular imaging and optimize the value received from it."

The ASNC MedAxiom 2012 Nuclear Trending Survey is available for sale at www.asnc.org.

Putting patient safety, resource stewardship firstAn ASNC2012 session focusing on the challenges of practice amid cost containment and safety concerns highlighted ASNC's contribution to the Choosing Wisely campaign, which emphasizes responsible, evidence-based medical decisions. "We must regulate ourselves by increasing the value of cardiac imaging, and we can begin to do this by not doing the tests in the ASNC Choosing Wisely list," said Mayo Clinic professor Dr. Raymond Gibbons. The session also delved into ASNC's guidance for limiting radiation exposure in myocardial perfusion imaging as well as the need for ongoing patient education regarding what is known about radiation safety and the benefits of screenings. "Perception is reality," said Ernest Garcia of Emory University School of Medicine. Cardiology Magazine online
(9/12)

EMRs, reminders improve adherence to SPECT AUCAppropriate ordering of SPECT myocardial perfusion imaging saw a fivefold increase when the 2009 appropriate use criteria for SPECT were embedded in EMR systems and primary care physicians received e-mail reminders, according to research presented at ASNC2012. The volume of SPECT MPI orders from PCPs also increased, suggesting the tests may be underutilized. Even among cardiologists, researchers saw a trend toward more appropriate utilization with implementation of the AUC tools. MedPage Today (free registration)
(9/11)

ASNC2012 Meeting on DemandPurchase your copy of ASNC2012 Meeting on Demand today. More than 40 educational sessions comprising audio recordings synchronized with speakers' slides will provide you with unlimited online access to this valuable program!

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